'Twas My Night Before Christmas by Greg R. Bobo, DVM
As all veterinarians know, it is almost impossible to plan for activities beyond work. I learned this early in my mixed-animal career one December night when, as I was literally walking out the door with my family to go to a large Christmas Eve dinner, the phone rang. For some crazy reason, I answered it.
"Is this the vet?" said the elderly voice on the other end. Now, either I was too slow on my feet to think to say "No" or I really wanted to build my clientele, but the end result is that I answered, "Yes. Can I help you?"
The caller explained that one of his best cows had calved earlier in the day and now had a "backward" uterus. I deducted that it was pretty mild and shouldn't take long to repair, plus I figured that in the process, I would gain a new lifelong client for my fledgling practice. After a brief consultation with my wife (who threatened me within an inch of my life to hurry) I was on my way. I pulled into the short driveway which had cars lined up and down it, and located the cow's owner. At the time, I didn't think twice about all the cars; it was after all Christmas Eve, a time to gather with loved ones. The owner informed me that the cow in question was in the pen on the other side of the house and that I could pull into the next driveway down the street go get closer to her.
I did as the owner instructed and remember thinking, "Boy this guy must have a huge family, I bet I'll have quite an audience tonight," because there were even more cars parked on this side of the house. As I was in mid-thought, however, something pulled out in front of me. A different man was driving a large forklift, and he was gesturing me to follow him. We had traveled only a short distance when I realized what the forklift was for. All of those cars did not belong to family or friends - - I was about to perform surgery in the middle of a junked car lot. The driver kindly picked up a pile of crushed vehicles, essentially creating a hole for me to drive up into the cow's pen. The entire fence was made of stacks of junked cars, crushed and lined up bumper to bumper - - the most unlikely of mangers for this yuletide visit.
The owner identified the cow and, shortly thereafter, we had her in position. After all of the chasing and roping the uterus had grown to about 2.5 feet long and now was quite edematous. I went straight to work and within 5 minutes managed to rupture the friable uterus in one place. I quickly sutured the tear and resumed replacing the uterus to its rightful location under the eyes of several neighbors who had been drawn by the bright light and activity.
By now, the poor cow's uterus had become so congested and friable, literally tearing with the slightest manipulation, that I began to question the owner about how significant she was to his herd. He responded by telling me she was really his best cow, and that he had hoped to raise this one last calf.
With the rapidly degenerating condition of her reproductive organs, I briefly touched on euthanasia but he really wanted to save her. I was searching the cloudless sky for an answer, when I overheard one of the neighbor's son's mention that he had been changing a flat bicycle tire when he saw the lights. Then it hit me like a bolt of Christmas lightening; I remembered one of my veterinary school clinicians mentioning a salvage procedure for a prolapsed uterus. The procedure involved amputation of the uterus using a strap of elastic as a permanent tourniquet. I discussed my plan with the owner, telling him that if the tourniquet came off, the cow would be dead in a very short time, but she had a 50-50 chance of making it through weaning. He okayed the procedure, and I sent the youngster over the fence to retrieve the bicycle inner tube. I fashioned it for the largest tourniquet that I had ever seen, disinfected it as best I could, and began to wrap it around the uterus as close to the cow as possible. The forklift driver and I pulled against each other to ensure the giant rubber band was permanently tightened. Finally, with all eyes watching, I selected a No#20 scalpel blade and began to amputate the organ, cutting through arteries the size of my finger. Miraculously, there was very little hemorrhaging. I held the stump where the uterus once was for a few minutes. Still no bleeding and the tourniquet was firmly holding in place. After saying a small prayer, I let go of the uterine pedicle and watched it disappear back into the cow.
I administered a clostridial booster and long-acting antibiotic before letting the cow go, and immediately she went over to her newborn and allowed him to nurse (as it turned out, the cow continued to do just fine per the owner). After a short round of thanks and congratulations from the owner and my audience, I loaded up, changed into my "dinner clothes," and headed out. My friendly forklift driver happily cleared an exit for me as I phoned my wife, Elizabeth, to say, "Honey, wait until you hear about this one." Definitely a Christmas to remember.
Featured in the December 2003 issue of Veterinary Forum